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Sound Scouts Screening Guide

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Hearing Screening Guide Sound Scouts is supported by

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Table of Contents 01 Why are hearing checks important for students 01 Types of hearing loss 02 What you will need 03 Choosing the right headphones 04 Planning a screening session 05 Setting up the screening environment 06 Supervising a Sound Scouts Test 08 How is the Sound Scouts hearing test structured 10 Script examples for supervisors 11 After the test 12 Understanding results 13 Failing the screening next steps 14 Things to consider before testing with Sound Scouts 15 Recommendations for school screening programs Support Material Understanding Sound Scouts results infographic Quiet Please testing in progress poster Speech in Noise Test target items printout Sound Scouts hearing checks at our school poster

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Why are hearing checks important for students An estimated 1 in 10 children suffer from hearing loss which left undetected can lead to speech learning and behavioural problems The World Health Organisation recommends that all children should have their hearing screened around the time they start school Every child starting school should have their hearing tested and ideally again in Year 3 Year 5 in line with NAPLAN Any child identified with learning or behavioural problems should have their hearing tested Types of hearing loss Conductive hearing loss middle ear occurs when something interferes with sound travelling to the inner ear Usually temporary it s often caused by fluid from middle ear infections but can also result from ear wax build up or a foreign object lodged in the ear canal It s estimated that around four out of five children will experience a middle ear infection at least once Hearing loss can occur even after symptoms resolve because fluid can remain in the ear Sensorineural hearing loss inner ear results from damage to the inner ear and is permanent It s often present from birth but can also be acquired through exposure to loud noise some medicines some viral infections and head injuries It exists on a spectrum ranging from mild to profound Hearing aids or for those with profound loss Cochlear implants can reduce the impact of a hearing loss Difficulty Hearing in Noise is a hearing issue than can occur despite a person receiving normal results in an audiogram While hearing in quiet may be normal hearing in noisy environments such as the classroom or a restaurant may be extremely difficult Difficulty hearing in noise can be caused by a number of things including but not limited to auditory processing disorder a developmental delay a language issue attention deficit and english as a second language or bi lingual multilingual capabilities 1

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What you will need Screening Guide Good quality adult headphones Internet access Parent permission note Apple or Android tablet loaded with the Sound Scouts App Alcohol wipes WARNING Using suitable good quality adult headphones is vital to ensuring the Sound Scouts test results are reliable 2

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Choosing the right headphones Choosing the right headphones and using them in the correct way is an important part of ensuring a reliable result when screening with Sound Scouts Use good quality adult headphones Do not use a splitter as they can reduce the sound levels heard by the person being tested Do not use gaming or surround sound headphones In the interests of hygiene do not use earbuds when screening in schools We recommend Sennheiser HD 300s over ear headphones for screening and offer these to schools using Sound Scouts Sennheiser HD 300 90 plus postage https www soundscouts com au schools headphone order form or email team soundscouts com au 3

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Planning a screening session 1 Obtain parental permission Parental permission is required to screen children You can use and modify the permission note template provided in our school resources for this purpose 4 2 Organise for staff and volunteers to help Create a roster of staff and or parent and community volunteers to help supervise screening Estimate how much time you will need Each test takes 8 minutes Allowing for changeover each supervising adult could screen 5 6 students per hour 5 3 Students can be screened in small groups Up to four students can be screened at the same time with two adult supervisors recommended especially when screening younger students Schedule screening in a quiet room Ensure a quiet room is available for screening Rooms with carpet are preferable 4

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Setting up the screening environment 1 Download Sound Scouts to an Apple or Android tablet 2 Please read our guidance on Choosing the right headphones Over ear headphones are best for screening in schools Ensure headphones are plugged in properly before getting started Ensure devices are fully charged have notifications switched off and have the latest version of Sound Scouts downloaded from the App Store or Google Play 4 Use good quality adult headphones 3 Ensure children are ready to focus Before testing make sure children are well rested have been to the bathroom and have blown their nose 5 Clean screens and headphones between tests Use alcohol wipes to clean screens and headphones between tests Disposable headphone protectors also help to stop the spread of germs 6 Test in a quiet place Test in a quiet indoor space free from distractions Noisy air conditioners or appliances may impact the results Set up the space to minimise distraction If more than one student is being screened in the same room face desks away from each other to avoid distraction 5

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Supervising a Sound Scouts test 1 Set the volume to maximum 2 To begin go to New Session Read and carefully follow the instructions on each page Before starting each test set the volume to maximum or to the highest comfortable listening level 4 Start a New Session NB We recommend supervisors complete a test to understand how it works 3 Player setup Select Create Player Enter a Player ID and email address We suggest using a designated school email for all Reports Monitor this email for Sound Scouts correspondence 5 Explain to children how the game works Tell the child that the sounds will get quieter and sometimes they may not be able to hear anything and that this is OK Advise them to wait and only tap the screen when they hear the sounds 6 Supervisor setup Supervising adults must play a short game based activity which can be done before the children arrive for testing This activity helps to calibrate the sound levels Ask the child to select the five words they know best When selecting the words for the first activity we recommend the child says each word out loud The Supervisor should guide them to choose the five items they know best 6

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7 Trial Run Use the Trial Run to ensure that the children understand how to interact with the three test activities Do not test children who cannot complete the trial activities 10 8 Headphones The children should be using the same headphones as those used by the Supervising adult Ensure the headphones are sitting correctly on or over the ears Intervene if the child is not interacting If the child is not responding you can listen in or ask them what they hear and tap or slide the matching object for them Demonstrating once or twice should be enough to prompt play If further assistance is required exit the test and use the Trial Run with the headphones out to deliver further explanation 11 9 Supervisors should supervise During the test supervisors should watch for on screen alerts They should also watch to ensure the child isn t tapping repeatedly when no sounds are presented Supervisors can prompt players to only tap when they hear a sound To end a test session If anything happens during the test that may impact the results e g persistent loud noise or child unwilling to complete you can exit the game by tapping 3 times on the top right corner of the screen or quit the app using the method appropriate to the device 7

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How is the Sound Scouts hearing test structured Sound Scouts incorporates three separate test activities in the 8 minute assessment Speech in Quiet Calibration Tone in Noise Speech in Noise The Sound Scouts hearing test is an interactive game for mobile devices built around these three tests with the calibration task providing one of the test metrics as well as being used to set the level of the targets stimuli for the following two test activities Each Player s results are compared with the results of players of the same age with normal hearing Part One Speech in Quiet Calibration Adult with good hearing completes a short game based activity to help establish sound levels for the test The speech in quiet activity uses two syllable words e g popcorn rainbow ice cream Supervising adult guides the child to select 5 items they recognise visually and verbally adult can ask the child to say each word out loud Child can select from 10 items Child to complete the same test for one ear and a similar test for the second ear using the selected words Child to tap or slide the spoken target item into the scene Check dexterity using Trial Run Items become progressively harder to hear until the child reaches their threshold i e the lowest volume at which they can hear Volume adapts automatically based on the child s responses so the child should only miss every second item once they reach their threshold provided they are responding reliably 8

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Part Two Tone in Noise Children are asked to listen for the beep from a helicopter s sound tracker and to press the red button when they hear the sound The children are visually rewarded when they correctly identify the sound The test ends when the child reaches their threshold and maintains consistent responses for a period of time OR after the set maximum number of presentations is made Part Three Speech in Noise Children are asked to listen to the spoken words and then drag the corresponding target item into the scene The items can be placed anywhere in the scene and will playfully adapt in size depending on where they are placed There is background dialogue throughout this section The player must focus on the target items which become increasingly difficult to hear against the background noise This test assesses the players ability to hear in noise Some children may be able to hear in quiet but due to language concentration or processing issues they may struggle to hear in noise Results When the child finishes the game the test results are immediately returned to the supervising adult on the device and via email The child s results are assessed against normal results for children of the same age Please RETEST all children who receive a Fail or Borderline result before taking further action 9

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Script examples for supervisors 10

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After the test 1 Results are delivered immediately 2 You can view the results on the device and they will also be automatically emailed to the address entered at the beginning 4 Wipe down screens and headsets and replace headphone protectors if applicable Stored results can be accessed through Past Sessions To retrieve a session go to Past Sessions select the session and if a connection is available the results will be processed 5 Clean the device and headphones Incomplete session Results won t be processed if the player does not complete all three activities 6 3 If you don t receive results If the device is not connected to a Wi Fi network the test data will be stored and can be processed when a connection becomes available You will not receive results until you connect to Wi Fi Phone hot spots can be used Read the report carefully and follow the next steps If a child receives a fail or borderline result please RETEST after 24 hours Follow the recommendations in the report unless advised otherwise by the Sound Scouts team 11

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Understanding results When the hearing check is complete a report is automatically generated The report is viewable on the device and is also sent via email when an address is provided Page 1 of the Report provides the overall result with an indication of the likely cause if a problem is detected Page 2 provides information on the results achieved in the three separate test activities Pass Borderline If the child receives a Pass the Report will state that the child has passed the Sound Scouts hearing check This means that the child s results are within the normal range for children of the same age If you have ongoing concerns about the child s hearing we strongly recommend seeing your GP or a hearing professional If the child receives a Borderline result hearing may be on the edge of normal When a Borderline result is received it is recommended that the child is retested after 24 hours If the child receives a similar result further investigation may be necessary Fail If the child receives a Fail result we recommend retesting after 24 hours If the child receives a second Fail result then further diagnostic assessment is recommended NB If there are reservations about the result i e the result is not in line with other indicators we recommend re testing or seeking further diagnostic assessment 12

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Failing the Screening Next Steps Students who fail the hearing screening may be flagged as having an issue in one of the following areas Middle ear Conductive hearing loss If the child receives a fail result with an indication of a middle ear or conductive hearing loss Sound Scouts recommend that the carer follow up with a visit to their doctor A middle ear issue may be caused by things such as a build up of wax or fluid and in most cases with the appropriate treatment hearing will return to normal Inner ear Sensorineural hearing loss If the child receives a fail result with an indication of an inner ear or sensorineural hearing loss the report recommends follow up with Hearing Australia or an audiologist for further evaluation Difficulty Hearing in Noise If the child receives a fail result with an indication of difficulty hearing in noise the possible causes need to be considered Difficulty hearing in noise can be caused by poor attention language disorders English as a second language ESL or EAL D and Auditory Processing Disorders APDs which are related to the brain s ability to process sounds Children who experience difficulty hearing in noise can typically hear in quiet environments but struggle in noisy environments like the classroom or playground By determining the most likely possible cause the child s care team can determine who best to see for further assessment A Sound Scouts fail result indicating sensorineural loss or difficulty hearing in noise is accepted as a referral for the purposes of obtaining an appointment with Hearing Australia 13

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Things to consider before testing with Sound Scouts In relation to children with cognitive issues Supervisors should confirm that they are able to successfully complete the Trial Run activities before undertaking a full test Those children who can not independently do the Trial Run activities should NOT be tested with Sound Scouts If English is not the child s primary language i e ESL or EAL D to complete Sound Scouts the Supervisor must determine if the child can identify 5 words from the list of 10 spondee items Provided they can identify 5 words we suggest they say them out loud then they should be able to undertake the test For these children please use the Trial Run with the headphones OUT to ensure they understand each of the three activities You may need to repeat several times The second activity the helicopter game is largely language independent so provided the children understand what to do i e tap the red button when they hear the stimuli target sound they will be able to complete this activity If the children can do the first two activities it should be possible to determine if they have a hearing loss It is likely children who speak English as a second language may get a borderline or fail result due to the final listening in noise activity This is a common outcome and is due to the children having to process complex audio bilingually The child s Report will note that the child has received a result outside the normal range due to difficulty hearing in noise which can be caused by the child speaking more than one language For reference the list of the speech in noise target items is available and can be used to assist ESL children in reviewing the items prior to testing Be careful not to overexpose children to the target words If the children CAN NOT identify 5 words then it s best to wait until they can or seek another type of hearing assessment 14

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Recommendations for school screening programs Sound Scouts recommends a couple of simple steps for schools to follow when it comes to organising Sound Scouts Reports and ensuring the right information is sent to parents We suggest sending all Sound Scouts Reports to one school email address When starting a screening session the app will ask for an email address Make sure everyone supervising the hearing tests knows which email address to enter and that it is entered correctly This email should be monitored for correspondence from the Sound Scouts team during testing If a child passes the test on their first attempt this report can be sent to the parents caregiver and a second test is not required Unless the Report flags an issue with the Supervisor levels If a child fails or receives a borderline result on their first test they will need to be re tested Do not send the report to their parents caregivers at this stage If on a child s second test they pass we suggest that you only send the parents the second report i e the pass result In this instance the first test result was likely caused by uncertainty or loss of attention when completing the test If a child fails or receives a borderline result on the second test we suggest sending both reports to the parents caregivers If a child requires a second test this should not be completed on the same day as their first test We recommend a 24 hour window between first and second tests although we do appreciate this may not always be possible When testing large cohorts it is useful to set up a spreadsheet with headings similar to below 15

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Sound Scouts levels the playing field by enabling children with hearing loss to be identified and the risks associated with hearing loss to be managed Meriel Special Educator Hearing SA Need more information 1300 424 122 team soundscouts com au Sound Scouts SoundScoutsGame www soundscouts com au 2021 Sound Scouts HQ Pty Ltd